Hodgkin's Lymphoma

(Hodgkin's Disease)

Definition

Hodgkin's lymphoma is a cancer of the lymphatic system. The lymphatic system drains excess fluid from the blood and protects against infection. Hodgkin's lymphoma is different from other forms of
lymphoma
.

Cancer occurs when cells in the body (in this case a type of white blood cell called lymphocyte) divide without control or order. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to
malignant tumors, which can invade nearby tissue and can spread to other parts of the body. A
benign tumor
does not invade or spread.

Causes

The cause of Hodgkin's lymphoma is unknown. It is likely related to complex genetic and environmental factors that lead to alteration of the immune system. There are some compelling pieces of data to suggest that it is caused by a virus, and the Epstein-Barr virus (EBV) has been considered.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include:

Sex: male

Ages: 15-40 and over 55

Family history

History of infectious
mononucleosis
or infection with Epstein-Barr virus, the causative agent of mononucleosis

Weakened immune system, including infection with
HIV
or the presence of
AIDS

Prolonged use of human growth hormone

Symptoms

Symptoms include:

Painless swelling of the lymph nodes in the neck, armpit, or groin

Persistent fatigue

Night sweating

Coughing

Unexplained fever

Weight loss

Itching

Decreased appetite

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. In particular, the doctor will carefully examine your lymph nodes. Most enlarged or swollen lymph nodes result from infection, not lymphomas. If infection is suspected, you may be given medication and instructed to return for re-examination.

If swelling persists, your doctor may order a lymph node
biopsy
. The biopsy results will show whether there is cancer, and if so, the type and extent of the cancer that is present.

Treatment of Hodgkinâ€™s disease depends on the stage of the disease: how far the cancer has spread and what organs are affected. In general, this means that staging tests to evaluate the condition of the lymph nodes in the body, the liver, spleen, and bone marrow must be done.

In addition:

CT scan
—a type of x-ray that uses a computer to make pictures of structures inside the body; done to evaluate the lymph nodes

Blood tests—to establish the condition of the liver and blood

PET scan
—an extremely sensitive way of evaluating the spread of the disease

Gallium scan—a test that uses a radioactive compound to scan and take pictures of your body

Abdominal surgery to remove the
spleen
and to
biopsy
the liver—much less common because of the accuracy of noninvasive scans

Treatment

Hodgkin's lymphoma is generally considered one of the more curable forms of cancer. The two primary ways of treating this cancer are:

Chemotherapy and External Radiation Therapy

Chemotherapy
is
the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.

In
radiation therapy
,
radiation is directed at the tumor from a source outside the body to kill the cancer cells.

In many cases, both chemotherapy and radiation are used to cure a patient of Hodgkinâ€™s lymphoma. The choice of treatments will be based on:

Extent of disease (the stage)

Location of the affected lymph node(s)

Many other patient-related features that your doctor will discuss with you

It is very important that you be seen by both the medical oncologist to discuss chemotherapy and the radiation oncologist to discuss the radiation therapy. It is not wise to see only one of these specialists since the best treatment results come from a discussion and integrated approach.

If the cancer does not respond to chemotherapy or radiation, the outcome is usually very poor. There are some treatment options available, including:

Bone marrow transplantation
—Bone marrow is removed, treated, and frozen. Large doses of chemotherapy and/or radiation therapy are then applied to kill the cancer cells. After treatment, the bone marrow is replaced via a vein. Transplanted bone marrow may be the patient's bone marrow that was treated to remove cancer cells or marrow from a healthy donor.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY.
Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.